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Cited by 23Nutrition and Health in AgingClinical Nutrition and GastroenterologyDietetics, Nutrition, and Education

A foodservice approach to enhance energy intake of elderly subacute patients: a pilot study to assess impact on patient outcomes and cost

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Collins, Jorja, Porter, Judi, Truby, Helen, Huggins, Catherine E.·2016·Age and Ageing
DOI 10.1093/ageing/afw238
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Abstract

Background: effective strategies are required to support the nutritional status of patients. Objectives: to evaluate a foodservice nutrition intervention on a range of participant outcomes and estimate its cost. Design: parallel controlled pilot study. Setting: subacute hospital ward. Subjects: all consecutively admitted adult patients were eligible for recruitment under waiver of consent. Methods: the intervention was a modified hospital menu developed by substituting standard items with higher energy options. The control was the standard menu. All participants received usual multidisciplinary care. Outcomes were change in weight and hand grip strength (HGS) between admission and day 14 and; energy and protein intake and patient satisfaction with the foodservice at day 14. The additional cost of the intervention was also estimated. Results: the median (interquartile range) age of participants (n = 122) was 83 (75-87) years and length of stay was 19 (11-32) days. One-third (38.5%) were malnourished at admission. There was no difference in mean (SD) HGS change (1.7 (5.1) versus 1.4 (5.8) kg, P = 0.798) or weight change (-0.55 (3.43) versus 0.26 (3.33) %, P = 0.338) between the intervention and control groups, respectively. The intervention group had significantly higher mean (SD) intake of energy (132 (38) versus 105 (34) kJ/kg/day, P = 0.003) and protein (1.4 (0.6) versus 1.1 (0.4) g protein/kg/day, P = 0.035). Both groups were satisfied with the foodservice. The additional cost was £4.15/participant/day. Conclusions: in this pilot, the intervention improved intake and may be a useful strategy to address malnutrition. Further consideration of clinical and cost implications is required in a fully powered study.

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  • In that pilot controlled trial, among patients with complete data, there was no difference between intervention and control in weight, handgrip strength, functional independence measure, or length of stay.

    “In those with complete data, there was no difference in patients' weight, HGS, functional independence measure or LOS.”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [159]

    The Results report no between-group difference in change in weight or handgrip strength from admission to day 14, and similar change in FIM score and length of stay. However, the Results specify that FIM and length-of-stay analyses included all participants, not only those with complete day-14 data. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • In that pilot controlled trial, energy and protein intake were higher in the intervention group (1725 vs 1863 kcal/day, p=0.21; 76 vs 80 g/day, p=0.59).

    “However, energy (1725 kcal/day vs. 1863 kcal/day, p ¼ 0.21) and protein (76 g/ day vs. 80 g/day, p ¼ 0.59) intake were higher in the IG.”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [159]

    The Results section reports higher energy and protein intake in the intervention group at day 14, with a significant difference after adjustment for weight. The available Table 2 text contains only its header, so our copy does not verify the quoted intake values or p-values; the Results passage does not give them. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • In that pilot controlled trial, the increase in energy and protein intake was statistically significant when adjusted for weight (p=0.03 for protein, p=0.003 for energy).

    “This increase was statistically significant when adjusted for weight (p ¼ 0.03 for protein, p ¼ 0.003 for energy intake) (Level of evidence 1-).”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [159]

    The Results section states that energy and protein intake at day 14 were significantly higher in the intervention group after adjustment for weight. The copy of Table 2 does not include the relevant data rows, so it cannot verify the attributed p-values of 0.03 and 0.003. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • In a pilot controlled trial in older patients (n=122) on a subacute ward, data were missing for 41.1% of patients on day 14.

    “Data were missing for 41.1% of patients on day 14.”

    From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [159]

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Cited by

Sorted by citations

Authors
Collins, J., Porter, J., Truby, H., & Huggins, C. E.
Affiliations
  • Monash University (AU)
  • Eastern Health (AU)
Corresponding author
Collins, Jorja
ORCID
Venue
Age and Ageing
Publisher
Oxford University Press (OUP)
Published
2016-12-14
Volume
46
Issue
3
Pages
486-493
ISSN
  • 0002-0729 (ISSN-L)
  • 1468-2834
DOI
10.1093/ageing/afw238
OpenAlex
W2561246971
Cited by
23
References
1
Citations by year
2026: 1 · 2025: 3 · 2024: 4 · 2023: 4 · 2022: 3 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 1 · 2017: 1
FWCI
1.07
Type
journal article
Language
en
Open access
Locations
  • Age and Ageing (publishedVersion)
  • PubMed (publishedVersion)
  • Deakin Research Online (Deakin University) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Funders
  • Dietetics and Foodservice departments of Eastern Health
  • Department of Nutrition and Dietetics, Monash University
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
Keywords
energy intake, protein intake, malnutrition, elderly patients, grip strength, weight change, patient satisfaction, intervention costs, nutritional status
MeSH terms
Age Factors, Aged, Aged, 80 and over, Aging, Energy Intake, Cost-Benefit Analysis, Dietary Proteins, Eating, Energy Metabolism, Female, Food Service, Hospital, Humans, Length of Stay, Male, Menu Planning, Nutritional Status, Pilot Projects, Time Factors, Victoria, Weight Gain, Geriatric Assessment, Nutrition Assessment, Treatment Outcome, Patient Satisfaction, Hospital Costs, Hand Strength, Recovery of Function, Malnutrition

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